Fillable Printable Form W-2c
Fillable Printable Form W-2c
Form W-2c
Attention:
This form is provided for informational purposes only. Copy A appears in red, similar to the
official IRS form. Do not file copy A downloaded from this website with the SSA. The official
printed version of this IRS form is scannable, but the online version of it, printed from this
website, is not. A penalty may be imposed for filing forms that can’t be scanned. See the
penalties section in the current General Instructions for Forms W-2 and W-3 for more
information.
To order official IRS forms, call 1-800-TAX-FORM (1-800-829-3676) or
Order Information
Returns and Employer Returns Online, and we’ll mail you the scannable forms and other
products.
You may file Forms W-2 and W-3 electronically on the SSA’s website at
Employer
Reporting Instructions & Information. You can create fill-in versions of Forms W-2 and W-3
for filing with SSA. You may also print out copies for filing with state or local governments,
distribution to your employees, and for your records.
See IRS Publications 1141, 1167, 1179 and other IRS resources for information about
printing these tax forms.
DO NOT CUT, FOLD, OR STAPLE THIS FORM
44444
For Official Use Only
▶
OMB No. 1545-0008
a Employer’s name, address, and ZIP code
b Employer's Federal EIN
c Tax year/Form corrected
/ W-2
d Employee’s correct SSN
e Corrected SSN and/or name (Check this box and complete boxes f and/or
g if incorrect on form previously filed.)
Complete boxes f and/or g only if incorrect on form previously filed
▶
f Employee’s previously reported SSN
g Employee’s previously reported name
h Employee’s first name and initial Last name Suff.
i Employee’s address and ZIP code
Note. Only complete money fields that are being corrected(exception: for
corrections involving MQGE, see the General Instructions for Forms W-2
and W-3, under Specific Instructionsfor Form W-2c, boxes 5 and 6).
Previously reported
1 Wages, tips, other compensation
Correct information
1 Wages, tips, other compensation
Previously reported
2 Federal income tax withheld
Correct information
2 Federal income tax withheld
3 Social security wages3 Social security wages4 Social security tax withheld4 Social security tax withheld
5 Medicare wages and tips5 Medicare wages and tips6 Medicare tax withheld6 Medicare tax withheld
7 Social security tips7 Social security tips
8 Allocated tips 8 Allocated tips
9
9
10 Dependent care benefits 10 Dependent care benefits
11 Nonqualified plans11 Nonqualified plans
12a See instructions for box 12
C
o
d
e
12a See instructions for box 12
C
o
d
e
12b
C
o
d
e
12b
C
o
d
e
12c
C
o
d
e
12c
C
o
d
e
12d
C
o
d
e
12d
C
o
d
e
13
Statutory
employee
Retirement
plan
Third-party
sick pay
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14 Other (see instructions) 14 Other (see instructions)
State Correction Information
Previously reported
15 State
Correct information
15 State
Previously reported
15 State
Correct information
15 State
Employer’s state ID number Employer’s state ID number Employer’s state ID number Employer’s state ID number
16 State wages, tips, etc. 16 State wages, tips, etc. 16 State wages, tips, etc. 16 State wages, tips, etc.
17 State income tax 17 State income tax 17 State income tax 17 State income tax
Locality Correction Information
Previously reported
18 Local wages, tips, etc.
Correct information
18 Local wages, tips, etc.
Previously reported
18 Local wages, tips, etc.
Correct information
18 Local wages, tips, etc.
19 Local income tax 19 Local income tax 19 Local income tax 19 Local income tax
20 Locality name 20 Locality name 20 Locality name 20 Locality name
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Copy A—For Social Security Administration
Form W-2c (Rev. 8-2014)
Corrected Wage and Tax Statement
Cat. No. 61437D
Department of the Treasury
Internal Revenue Service
44444
For Official Use Only
▶
OMB No. 1545-0008
a Employer’s name, address, and ZIP code
b Employer's Federal EIN
c Tax year/Form corrected
/ W-2
d Employee’s correct SSN
e Corrected SSN and/or name (Check this box and complete boxes f and/or
g if incorrect on form previously filed.)
Complete boxes f and/or g only if incorrect on form previously filed
▶
f Employee’s previously reported SSN
g Employee’s previously reported name
h Employee’s first name and initial Last name Suff.
i Employee’s address and ZIP code
Note. Only complete money fields that are being corrected(exception: for
corrections involving MQGE, see the General Instructions for Forms W-2
and W-3, under Specific Instructions for Form W-2c, boxes 5 and 6).
Previously reported
1 Wages, tips, other compensation
Correct information
1 Wages, tips, other compensation
Previously reported
2 Federal income tax withheld
Correct information
2 Federal income tax withheld
3 Social security wages3 Social security wages4 Social security tax withheld4 Social security tax withheld
5 Medicare wages and tips5 Medicare wages and tips6 Medicare tax withheld6 Medicare tax withheld
7 Social security tips7 Social security tips
8 Allocated tips 8 Allocated tips
9
9
10 Dependent care benefits 10 Dependent care benefits
11 Nonqualified plans11 Nonqualified plans
12a See instructions for box 12
C
o
d
e
12a See instructions for box 12
C
o
d
e
12b
C
o
d
e
12b
C
o
d
e
12c
C
o
d
e
12c
C
o
d
e
12d
C
o
d
e
12d
C
o
d
e
13
Statutory
employee
Retirement
plan
Third-party
sick pay
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14 Other (see instructions) 14 Other (see instructions)
State Correction Information
Previously reported
15 State
Correct information
15 State
Previously reported
15 State
Correct information
15 State
Employer’s state ID number Employer’s state ID number Employer’s state ID number Employer’s state ID number
16 State wages, tips, etc. 16 State wages, tips, etc. 16 State wages, tips, etc. 16 State wages, tips, etc.
17 State income tax 17 State income tax 17 State income tax 17 State income tax
Locality Correction Information
Previously reported
18 Local wages, tips, etc.
Correct information
18 Local wages, tips, etc.
Previously reported
18 Local wages, tips, etc.
Correct information
18 Local wages, tips, etc.
19 Local income tax 19 Local income tax 19 Local income tax 19 Local income tax
20 Locality name 20 Locality name 20 Locality name 20 Locality name
Form W-2c (Rev. 8-2014)
Corrected Wage and Tax Statement
Copy 1—State, City, or Local Tax Department
Department of the Treasury
Internal Revenue Service
44444
For Official Use Only
▶
OMB No. 1545-0008
Safe, accurate,
FAST! Use
Visit the IRS website
at www.irs.gov.
a Employer’s name, address, and ZIP code
b Employer's Federal EIN
c Tax year/Form corrected
/ W-2
d Employee’s correct SSN
e Corrected SSN and/or name (Check this box and complete boxes f and/or
g if incorrect on form previously filed.)
Complete boxes f and/or g only if incorrect on form previously filed
▶
f Employee’s previously reported SSN
g Employee’s previously reported name
h Employee’s first name and initial Last name Suff.
i Employee’s address and ZIP code
Note. Only complete money fields that are being corrected(exception: for
corrections involving MQGE, see the General Instructions for Forms W-2
and W-3, under Specific Instructionsfor Form W-2c, boxes 5 and 6).
Previously reported
1 Wages, tips, other compensation
Correct information
1 Wages, tips, other compensation
Previously reported
2 Federal income tax withheld
Correct information
2 Federal income tax withheld
3 Social security wages3 Social security wages4 Social security tax withheld4 Social security tax withheld
5 Medicare wages and tips5 Medicare wages and tips6 Medicare tax withheld6 Medicare tax withheld
7 Social security tips7 Social security tips
8 Allocated tips 8 Allocated tips
9
9
10 Dependent care benefits 10 Dependent care benefits
11 Nonqualified plans11 Nonqualified plans
12a See instructions for box 12
C
o
d
e
12a See instructions for box 12
C
o
d
e
12b
C
o
d
e
12b
C
o
d
e
12c
C
o
d
e
12c
C
o
d
e
12d
C
o
d
e
12d
C
o
d
e
13
Statutory
employee
Retirement
plan
Third-party
sick pay
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14 Other (see instructions) 14 Other (see instructions)
State Correction Information
Previously reported
15 State
Correct information
15 State
Previously reported
15 State
Correct information
15 State
Employer’s state ID number Employer’s state ID number Employer’s state ID number Employer’s state ID number
16 State wages, tips, etc. 16 State wages, tips, etc. 16 State wages, tips, etc. 16 State wages, tips, etc.
17 State income tax 17 State income tax 17 State income tax 17 State income tax
Locality Correction Information
Previously reported
18 Local wages, tips, etc.
Correct information
18 Local wages, tips, etc.
Previously reported
18 Local wages, tips, etc.
Correct information
18 Local wages, tips, etc.
19 Local income tax 19 Local income tax 19 Local income tax 19 Local income tax
20 Locality name 20 Locality name 20 Locality name 20 Locality name
Form W-2c (Rev. 8-2014)
Corrected Wage and Tax Statement
Copy B—To Be Filed with Employee’s FEDERAL Tax Return
Department of the Treasury
Internal Revenue Service
44444
For Official Use Only
▶
OMB No. 1545-0008
Safe, accurate,
FAST! Use
Visit the IRS website
at www.irs.gov.
a Employer’s name, address, and ZIP code
b Employer's Federal EIN
c Tax year/Form corrected
/ W-2
d Employee’s correct SSN
e Corrected SSN and/or name (Check this box and complete boxes f and/or
g if incorrect on form previously filed.)
Complete boxes f and/or g only if incorrect on form previously filed
▶
f Employee’s previously reported SSN
g Employee’s previously reported name
h Employee’s first name and initial Last name Suff.
i Employee’s address and ZIP code
Note. Only complete money fields that are being corrected (exception: for
corrections involving MQGE, see the General Instructions for Forms W-2
and W-3, under Specific Instructionsfor Form W-2c, boxes 5 and 6).
Previously reported
1 Wages, tips, other compensation
Correct information
1 Wages, tips, other compensation
Previously reported
2 Federal income tax withheld
Correct information
2 Federal income tax withheld
3 Social security wages3 Social security wages4 Social security tax withheld4 Social security tax withheld
5 Medicare wages and tips5 Medicare wages and tips6 Medicare tax withheld6 Medicare tax withheld
7 Social security tips7 Social security tips
8 Allocated tips 8 Allocated tips
9
9
10 Dependent care benefits 10 Dependent care benefits
11 Nonqualified plans11 Nonqualified plans
12a See instructions for box 12
C
o
d
e
12a See instructions for box 12
C
o
d
e
12b
C
o
d
e
12b
C
o
d
e
12c
C
o
d
e
12c
C
o
d
e
12d
C
o
d
e
12d
C
o
d
e
13
Statutory
employee
Retirement
plan
Third-party
sick pay
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14 Other (see instructions) 14 Other (see instructions)
State Correction Information
Previously reported
15 State
Correct information
15 State
Previously reported
15 State
Correct information
15 State
Employer’s state ID number Employer’s state ID number Employer’s state ID number Employer’s state ID number
16 State wages, tips, etc. 16 State wages, tips, etc. 16 State wages, tips, etc. 16 State wages, tips, etc.
17 State income tax 17 State income tax 17 State income tax 17 State income tax
Locality Correction Information
Previously reported
18 Local wages, tips, etc.
Correct information
18 Local wages, tips, etc.
Previously reported
18 Local wages, tips, etc.
Correct information
18 Local wages, tips, etc.
19 Local income tax 19 Local income tax 19 Local income tax 19 Local income tax
20 Locality name 20 Locality name 20 Locality name 20 Locality name
Form W-2c (Rev. 8-2014)
Corrected Wage and Tax Statement
Copy C—For EMPLOYEE’s RECORDS
Department of the Treasury
Internal Revenue Service
Notice to Employee
This is a corrected Form W-2, Wage and Tax Statement,
(or Form W-2AS, W-2CM, W-2GU, W-2VI or W-2c) for the
tax year shown in box c. If you have filed an income tax
return for the year shown, you may have to file an
amended return. Compare amounts on this form with
those reported on your income tax return. If the corrected
amounts change your U.S. income tax, file Form 1040X,
Amended U.S. Individual Income Tax Return, with Copy B
of this Form W-2c to amend the return you already filed.
If there is a correction in box 5, Medicare wages and
tips, use the corrected amount to determine if you need
to file or amend Form 8959, Additional Medicare Tax. If
you need to file Form 8959 or an amended Form 8959,
attach it to Form 1040 or Form 1040X, as applicable.
If you have not filed your return for the year shown in
box c, attach Copy B of the original Form W-2 you
received from your employer and Copy B of this Form
W-2c to your return when you file it.
For more information, contact your nearest Internal
Revenue Service office. Employees in American Samoa,
Commonwealth of the Northern Mariana Islands, Guam,
or the U.S. Virgin Islands should contact their local taxing
authority for more information.
44444
For Official Use Only
▶
OMB No. 1545-0008
a Employer’s name, address, and ZIP code
b Employer's Federal EIN
c Tax year/Form corrected
/ W-2
d Employee’s correct SSN
e Corrected SSN and/or name (Check this box and complete boxes f and/or
g if incorrect on form previously filed.)
Complete boxes f and/or g only if incorrect on form previously filed
▶
f Employee’s previously reported SSN
g Employee’s previously reported name
h Employee’s first name and initial Last name Suff.
i Employee’s address and ZIP code
Note. Only complete money fields that are being corrected(exception: for
corrections involving MQGE, see the General Instructions for W-2 and W-3,
under Specific Instructions for Form W-2c, boxes 5 and 6).
Previously reported
1 Wages, tips, other compensation
Correct information
1 Wages, tips, other compensation
Previously reported
2 Federal income tax withheld
Correct information
2 Federal income tax withheld
3 Social security wages3 Social security wages4 Social security tax withheld4 Social security tax withheld
5 Medicare wages and tips5 Medicare wages and tips6 Medicare tax withheld6 Medicare tax withheld
7 Social security tips7 Social security tips
8 Allocated tips 8 Allocated tips
9
9
10 Dependent care benefits 10 Dependent care benefits
11 Nonqualified plans11 Nonqualified plans
12a See instructions for box 12
C
o
d
e
12a See instructions for box 12
C
o
d
e
12b
C
o
d
e
12b
C
o
d
e
12c
C
o
d
e
12c
C
o
d
e
12d
C
o
d
e
12d
C
o
d
e
13
Statutory
employee
Retirement
plan
Third-party
sick pay
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14 Other (see instructions) 14 Other (see instructions)
State Correction Information
Previously reported
15 State
Correct information
15 State
Previously reported
15 State
Correct information
15 State
Employer’s state ID number Employer’s state ID number Employer’s state ID number Employer’s state ID number
16 State wages, tips, etc. 16 State wages, tips, etc. 16 State wages, tips, etc. 16 State wages, tips, etc.
17 State income tax 17 State income tax 17 State income tax 17 State income tax
Locality Correction Information
Previously reported
18 Local wages, tips, etc.
Correct information
18 Local wages, tips, etc.
Previously reported
18 Local wages, tips, etc.
Correct information
18 Local wages, tips, etc.
19 Local income tax 19 Local income tax 19 Local income tax 19 Local income tax
20 Locality name 20 Locality name 20 Locality name 20 Locality name
Form W-2c (Rev. 8-2014)
Corrected Wage and Tax Statement
Copy 2—To Be Filed with Employee’s State, City, or Local Income Tax Return
Department of the Treasury
Internal Revenue Service
44444
For Official Use Only
▶
OMB No. 1545-0008
a Employer’s name, address, and ZIP code
b Employer's Federal EIN
c Tax year/Form corrected
/ W-2
d Employee’s correct SSN
e Corrected SSN and/or name (Check this box and complete boxes f and/or
g if incorrect on form previously filed.)
Complete boxes f and/or g only if incorrect on form previously filed
▶
f Employee’s previously reported SSN
g Employee’s previously reported name
h Employee’s first name and initial Last name Suff.
i Employee’s address and ZIP code
Note. Only complete money fields that are being corrected(exception: for
corrections involving MQGE, see the General Instructions for W-2 and W-3,
under Specific Instructionsfor Form W-2c, boxes 5 and 6).
Previously reported
1 Wages, tips, other compensation
Correct information
1 Wages, tips, other compensation
Previously reported
2 Federal income tax withheld
Correct information
2 Federal income tax withheld
3 Social security wages3 Social security wages4 Social security tax withheld4 Social security tax withheld
5 Medicare wages and tips5 Medicare wages and tips6 Medicare tax withheld6 Medicare tax withheld
7 Social security tips7 Social security tips
8 Allocated tips 8 Allocated tips
9
9
10 Dependent care benefits 10 Dependent care benefits
11 Nonqualified plans11 Nonqualified plans
12a See instructions for box 12
C
o
d
e
12a See instructions for box 12
C
o
d
e
12b
C
o
d
e
12b
C
o
d
e
12c
C
o
d
e
12c
C
o
d
e
12d
C
o
d
e
12d
C
o
d
e
13
Statutory
employee
Retirement
plan
Third-party
sick pay
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14 Other (see instructions) 14 Other (see instructions)
State Correction Information
Previously reported
15 State
Correct information
15 State
Previously reported
15 State
Correct information
15 State
Employer’s state ID number Employer’s state ID number Employer’s state ID number Employer’s state ID number
16 State wages, tips, etc. 16 State wages, tips, etc. 16 State wages, tips, etc. 16 State wages, tips, etc.
17 State income tax 17 State income tax 17 State income tax 17 State income tax
Locality Correction Information
Previously reported
18 Local wages, tips, etc.
Correct information
18 Local wages, tips, etc.
Previously reported
18 Local wages, tips, etc.
Correct information
18 Local wages, tips, etc.
19 Local income tax 19 Local income tax 19 Local income tax 19 Local income tax
20 Locality name 20 Locality name 20 Locality name 20 Locality name
Form W-2c (Rev. 8-2014)
Corrected Wage and Tax Statement
Copy D—For Employer
Department of the Treasury
Internal Revenue Service
Employers, Please Note:
Specific information needed to complete Form W-2c is
given in the separate General Instructions for Forms W-2
and W-3, under Specific Instructions for Form W-2c. You
can order those instructions and additional forms by
calling 1-800-TAX-FORM (1-800-829-3676). You can
also get forms and instructions from the IRS website at
www.irs.gov.
E-filing. If you file 250 or more Form(s) W-2c, you must
file electronically. Even if you are not required to file
electronically, doing so can save you time and effort.
Employers may now use the SSA's W-2 Online service to
create, save, print and submit up to 50 Form(s) W-2c at a
time over the Internet. When you e-file with the SSA, no
separate Form W-3c filing is required. An electronic Form
W-3c will be created for you by the W-2 Online service.
For information, visit the SSA's Employer W-2 Filing
Instructions & Information website at
www.socialsecurity.gov/employer.
